Genomic Test

[Hillwalker87]

Hi everyone! Would there be a benefit to my father seeking a genomic test? What does this usually determine? Also, anywhere anyone can suggest given we are in the UK? Thanks again

[LearnAll]

Every man diagnosed with metastatic PCa should go for Germline testing at earliest.Because it tells if there are inherited mutations or not. The treatment may vary based on these mutations . Some of these are BRCA1, BRCA 2, ATM, Check etc.

In USA, the company COLOR GENOMICS do the saliva test for these mutation for a cost of about $150. I got this test from Color.Com and it did not show any germline mutation...giving relief and peace of mind to me.

[Hillwalker87 in reply to LearnAll]

Thanks LA, I'll relay this to him

[Tall_Allen]

There are two kinds: somatic (tumor tissue) and germline (inherited). Germline tests are cheap and inexpensive. There is really only one possible germline finding (BRCA2) that has treatment implications. On somatic testing, BRCA2 would also be useful. In addition, there are a couple of extremely rare mutations that are actionable.

[Hillwalker87 in reply to Tall_Allen]

Thanks TA, sounds like it's worth looking into

[Cooolone]

The benefit would be indentifying any genetic mutations that are actionable as noted. There are some 500+ mutations now associated with PCa, but only a few with drugs that can offset the mutations. Here in the U.S. there are some trials that provide access to the extensive testing. I believe the trial was/is named "IMPACT"... Not sure if it's international.

Edit: UK IMPACT

impact.icr.ac.uk/blog/

Additional issue is side effects from gene therapy which sometimes can be worse than the affliction! Most involve tweaking your immune system (checkpoint inhibitors) which then can attack healthy tissue as well. So it's not a simple thing to just identify the genetic mutation and then take a pill. Also, the drugs have been shown to work for only a period of time, like most drugs. A timeline different for every patient of course, but still need to be aware that it's not a one pill cure type thing.

As noted, Germline mutations are what you're born with. Somatic mutations are what cellular changes occur due to stressors, toxins, environment, diet and a host of other influences, even prior treatment for PCa can cause genetic somatic mutations. The best tests are performed on the actual tissue from tumors! Including immunochemistry staining.

Many of the genetic therapies are also reserved for patients who become castrate resistant as well. So if you're not metastatic, not CRPC, etc., you won't qualify for the drug (U.S.) and can only then get it of a doctor will issue a prescription for off label use.

Not an easy thing to do!

A complicated subject to say the least.

[duncansdad in reply to Cooolone]

Excellent explanation of the two different tests. Thank you.

[westerville in reply to Cooolone]

So the Somatic test on my tumor I took would be for the Agent Orange exposure in Vietnam that changed my DNA . Hope to find out tomorrow (actually today darn insomnia ) what treatment the doctor keeps talking about but never explains what it is . I was tested negative on the genetic blood panel . More information 4/8 . Have to wait till Monday to find what my positive test means . Doctor Monk at The James Cancer center only works on Monday and Tuesday . But I got a call from Doctor Dattoli in Sarasota . He read my history since I last had DART radiation treatment by him in 2012 . He said I need more test so he's setting up tests in University of Michigan in Ann Arbor . So as soon as I have my zoom call at the James I call Dr. Dattoli . He said whatever it is like immunotherapy or other he can add radiation to boost my immune system . He talks about the whole alphabets and I couldn't write them down . So sorry about not giving more specific information but its been a crazy week .

[Hillwalker87 in reply to westerville]

I hope all went well for you mate

[Hillwalker87 in reply to Cooolone]

That's a great explanation, thanks for taking the time to form such a concise response

[lcfcpolo]

Hi Hillwalker. I live in the UK and did the COLOR test that this USA company offer. It is easy to do, just saliva needed. DHL delivered the test kit and collected it. About 5 to 6 weeks altogether from order to receiving results. It confirms if BRC1 or 2.

[Hillwalker87 in reply to lcfcpolo]

That's great mate,I'll have a look at that then. Say you test positive for any of the mutations, what happens then?

[lcfcpolo]

If you test positive you should discuss with your consultant. They do have different treatment options for those with some mutations. COLOR check for about 15 DNA mutations altogether. I was negative. If you were positive it MAY indicate inherited within the family. You would need to seek counselling help and support before discussing with other family members.

[Hillwalker87 in reply to lcfcpolo]

That's great, thanks again for the info!